Model Medicaid Addenda

Unless otherwise specified in the provider agreement or Ohio Administrative Code (OAC) rule 5160-26-05, MCPs are required to enter into fully executed subcontracts with their providers. These subcontracts must include a baseline contractual agreement, as well as the appropriate model Medicaid Addendum. The model Medicaid Addendums incorporate all applicable OAC rule requirements specific to provider subcontracting and therefore cannot be modified except to add personalizing information such as the MCP's name.

 

If you have any questions regarding the use of the model Medicaid Addendums or if you want a Word version of the documents provided electronically please contact the BMC at (614) 466-4693.

 

Medicaid Addendum
Used when contracting with providers for the provision of health care services to members.

 

Medicaid Delegation Subcontract Addendum
Used when contracting with entities for the purpose of fulfilling any of the administrative requirements specified in the provider agreement between the MCP and ODM (e.g., provider credentialing, utilization review, etc...).

 

Medicaid Combined Services Subcontract Addendum
Used when contracting with providers/entities for the provision of both health care services to members and the fulfillment of any administrative requirements specified in the MCP/ODM provider agreement (e.g., pharmacy benefit manager for the provision of pharmacy services and claims processing).